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Gov. Bill Haslam
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Despite regular broadsides against expanding the role of the federal government, Tennessee Republicans in Congress aren't criticizing Gov. Bill Haslam for ceding more control over health care to Uncle Sam.

Haslam on Monday became one of at least 18 governors to reject a state-run health insurance exchange, instead allowing the U.S. Department of Health and Human Services to establish and operate such an exchange for up to 558,000 uninsured Tennesseans. Undecided governors have until Friday to make a choice.

Most Tennessee Republican lawmakers support state and local control in almost everything affecting American life. But there were no recriminations for Haslam's deference to the federal government in running the biggest public health initiative since Medicare.

The official website of U.S. Rep. Scott DesJarlais, R-Tenn., says "health care decisions need to be left to patients and their physicians -- not bureaucrats in Washington."

On Monday, a DesJarlais Twitter message thanked Haslam for rejecting a state-run exchange, implicitly applauding the decision to yield administrative power to a Washington-based federal agency with 64,000 employees.

DesJarlais' office declined to comment, but in a Tennessean op-ed, he claimed a state-run exchange would be "a logistical nightmare."

Feelings are similar in the Senate. A former governor and onetime education secretary for President George H.W. Bush, U.S. Sen. Lamar Alexander, R-Tenn., has pushed for states to set their own standards for schools, teachers and students.

In a 2011 New York Times piece critical of "the Washington-imposed" No Child Left Behind Act, Alexander wrote: "Washington can't create good jobs, and Washington can't create good schools."

On Tuesday the Maryville Republican took another approach when asked about the Affordable Care Act.

"Given the number of unanswered questions about federal control of a state exchange and state tax dollars, it certainly is a reasonable decision," Alexander said of Haslam's choice to cede authority.

Similarly, U.S. Rep. Chuck Fleischmann, R-Tenn., often slams "Obamacare" as an overreach. At one debate, he said "the federal government took over one-sixth of our economy in a bill that was not even read."

But Tuesday the congressman refused to apply that criticism to Haslam's decision to let the federal government implement a statewide insurance market.

"Rep. Fleischmann makes no secret of his principled opposition to Obamacare," spokesman Alek Vey said. "However, decisions about how to implement Obamacare in Tennessee are made at the state level by the governor and the Legislature."

Democrats pounced on what they see as hypocrisy and sabotage against President Obama.

"It is obvious politics played a substantial part in the governor's decision," U.S. Rep. Steve Cohen, D-Tenn., said in a statement. "Governor Haslam has surrendered the chance to establish an exchange program tailored to Tennessee's specific needs."

Throughout his decision-making process, Haslam considered a state-run exchange, indicating he believed his administration could run a less costly exchange with better service. Former U.S. Senate Majority Leader Bill Frist agreed, writing in a Huffington Post op-ed piece that a Tennessee-run exchange presents "a distinctly American opportunity to shape eligibility requirements and other details."

But Haslam put a lid on state-run talk as conservative legislators and tea party activists protested. The governor insisted political pressure played no role in his choice, adding that he never got enough guidance, information and decision-making ability from the Obama administration.

At least 15 states want to run their own exchanges, but Haslam's explanation was enough for U.S. Sen. Bob Corker, R-Tenn.

"As usual, Sen. Corker defers to Governor Haslam and the legislature to make what they believe is the best decision for Tennessee," Corker spokeswoman Laura Herzog said.

Contact staff writer Chris Carroll at or 423-757-6610.